CARE HOMES FOR OLDER PEOPLE
Fairfields Country Rest Home Launcells Bude Cornwall EX23 9NH Lead Inspector
Mike Stokes Unannounced Inspection 15th September 2005 10:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Fairfields Country Rest Home DS0000009172.V258411.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Fairfields Country Rest Home DS0000009172.V258411.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Fairfields Country Rest Home Address Launcells Bude Cornwall EX23 9NH Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01288 381241 01288 381199 Mr Terence Pantling Mrs Linda Pantling Helen Goodgroves Care Home 26 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (26) of places Fairfields Country Rest Home DS0000009172.V258411.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. To include 1 named service user with a mental disorder, excluding learning disability or dementia (MD(E) Total number of service users not to exceed a maximum of 26 Date of last inspection 22/2/05 Brief Description of the Service: Fairfield is a single-storey building providing level accommodation for older people with en suite bedrooms that are mainly for single occupation. The majority of the bedrooms look over the gardens or countryside. There is a large dining room with views over the surrounding countryside. At the centre of the home is an attractive garden room. The home has been altered to include the addition of a new spacious lounge and improved bathing/shower facilities, hairdressing salon and two new en-suite bedrooms. This accommodation has been completed to a high standard. The grounds surrounding the home are spacious and parking is available at the home. Fairfields Country Rest Home DS0000009172.V258411.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection organised to look at the care standards in the home. I arrived at 10.30am and the inspection finished at 2.30pm. On this occasion Mr and Mrs Pantling were not at the home and the deputy manager and staff assisted by providing information contained in records and discussion. Various service users were met at the home and discussed a range of topics about living in the home. I was able to meet the cook and observe the main midday meal presented for service users. A partial tour of the home was completed through the inspection process. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Fairfields Country Rest Home DS0000009172.V258411.R01.S.doc Version 5.0 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Fairfields Country Rest Home DS0000009172.V258411.R01.S.doc Version 5.0 Page 7 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 5. The registered person has provided a statement of purpose and service users guide that details the facilities and services available within the home. The registered manager will assess all prospective service users prior to admission to ensure that the home can meet their care needs. EVIDENCE: A statement of purpose is available within the home and a service users guide has been issued to each service user. These documents explain the services and facilities available within the home as part of the contract and that hairdressing, chiropody and newspapers can be provided at the home and are at the service users expense. The registered manager visits prospective service users in their own home or in hospital prior to admission to complete an assessment process. These records include information received from other agencies to assist in appropriate admissions to the home. Prospective service users are invited to see the home and are involved in the completion of the dependency assessment documents.
Fairfields Country Rest Home DS0000009172.V258411.R01.S.doc Version 5.0 Page 8 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 9. The health care needs of service users are met with evidence of multi disciplinary working taking place on a regular basis. EVIDENCE: There are care plans for all service users that are developed from assessments and used by all key staff to ensure appropriate care is given. This is done with reference to dependency ratings and risk assessments that are reviewed regularly and monitored. 3 plans of care were inspected and these appropriately referred to the various needs of service users regarding medication, mobility, preferred assistance with personal care and nutrition. The plans detailed aids and adaptations to be used and action to be taken by staff to monitor service users at risk of falling. The homes accident book and procedures to report incidents in reference to regulation 37 are appropriately maintained. A range of pressure relieving equipment is provided for service users and liaison occurs with the community nursing service to provide for the welfare of service users. Service users are registered with local GP’s in Stratton Medical Centre and Holsworthy Health Centre. The administration of medication was observed and appropriate procedures; records and staff training are provided.
Fairfields Country Rest Home DS0000009172.V258411.R01.S.doc Version 5.0 Page 9 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 and 15. Service users exercise their choice to enjoy the privacy of their own rooms or join other service users in communal areas for company or meals. Service users maintain contact with visiting relatives and friends at the home. Service users are predominantly dependent on these contacts to access community facilities and the registered provider will organise trips, visiting entertainers and group activities at the home. The meals provided in the home are good with special diets catered for. EVIDENCE: Service users were met in communal areas or their own rooms. Service users bring items of furniture and possessions such as televisions, radios and CD players. Service users expressed approval that regular visits are received from their relatives. The opportunity to meet visiting relatives did not occur but records of visits are maintained. The service users stated that this was a quiet rural area with limited public transport services and that the nearest shops were a few miles away. The minutes of the service users meeting dated 6/9/05 detailed their approval of the trips arranged, the summer fete organised at the home and how the gardens were well maintained. The main midday meal was a roast dinner and this was served to service users from a trolley in the dining room to provide an individually plated service.
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The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. The registered provider uses the policy and procedures at the home to assist in the protection of service users. EVIDENCE: The complaints procedure containing the Commissions contact number and address was displayed in the home and is detailed in the service users guide. The registered person ensures that day-to-day control and regular contact with service users provides the opportunity to monitor standards. The registered person has provided appropriate ‘Protection’ policy and procedures. Fairfields Country Rest Home DS0000009172.V258411.R01.S.doc Version 5.0 Page 11 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22 and 26. The registered person is investing in the home to improve the facilities and provide a comfortable, safe environment for service users. EVIDENCE: The grounds are well maintained and offer views across the countryside and sea views. Communal space at the home includes the lounge, dining room and the garden room. The spacious, shared communal areas are bright and seating is set to encourage small social gatherings. There are sufficient toilet and bathroom facilities; all bedrooms have en-suite toilets and 10 rooms also have en-suite showers. The home is on one level and grab rails are in place to assist service users along corridors to their bedrooms. A recommendation is made to provide signs in the corridor areas to assist service users with their orientation in finding communal areas. An accessible call bell system is provided in each room. The home provides modern industrial washing and drying equipment to maintain an efficient laundry service. Care staff are also expected to complete some domestic duties, a domestic is employed and the home presented as clean, pleasant and hygienic. Appropriate hand washing facilities and disposable gloves and aprons are readily available.
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The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 and 30. The registered manager is providing suitably trained staff, in appropriate numbers to provide for the welfare of service users. EVIDENCE: There is a minimum of 2 carers at all times with 6 carers at peak times of activity, including management and ancillary staff. 2 waking night carers are provided for service users that require attention at night. The recruitment procedures and records were reviewed for staff and the registered person was able to provide written references and records regarding this process. The registered person has a commitment to providing a trained workforce and individual staff files contain training schedules and opportunities. Appropriate training is occurring at NVQ level 2, 3 and 4, food hygiene, moving and handling, first aid, infection control and health and safety. Further training is planned and the induction records for individual staff are signed and dated. The service users expressed approval of the services and attention received from care staff at the home. Fairfields Country Rest Home DS0000009172.V258411.R01.S.doc Version 5.0 Page 13 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 35 and 38. The registered persons are providing clear and effective leadership and management to maintain a safe and comfortable home for service users. EVIDENCE: The registered manager is in regular contact with service users and staff to monitor standards at the home. The registered manager is completing the Registered Managers Award and has appropriate experience in care settings. Appropriate communication systems are maintained and the minutes of the staff meeting 30/8/05 were inspected. Quality assurance survey’s are planned and will be reviewed at the next inspection. The registered manager conducts safety checks, maintenance and repairs to the home. Staff training is provided in fire precautions and first aid. The registered manager is advised to continue the review of this standard to ensure the health, safety and welfare of service users are promoted and protected. Records regarding service users finances have monthly management checks. A requirement is made to provide an appropriate record of service users valuables deposited for safekeeping.
Fairfields Country Rest Home DS0000009172.V258411.R01.S.doc Version 5.0 Page 14 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 2 X X X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X 2 X X 3 Fairfields Country Rest Home DS0000009172.V258411.R01.S.doc Version 5.0 Page 15 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP35 Regulation 17 Requirement The registered manager must provide records with reference to schedule 4.9 of this regulation. Timescale for action 30/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP22 Good Practice Recommendations The Registered Manager should provide signs in the corridors to assist service users with their orientation in finding communal areas at the home. Fairfields Country Rest Home DS0000009172.V258411.R01.S.doc Version 5.0 Page 16 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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